Hanging By A Thread
by liberalkid
Summary: Season 5. Doug gets hit by a car. Carol faints. Lots of medical fun.


Author's Note: This is set to take place in Season 5. I don't own anyone or anything. (It's a shame too. 'Cause if I did, Lizzie, Susan Lewis, Carter, Doug, Carol, Mark, and Gallant would never have left.)

Chapter One

The night shift of CoOkay County General Emergency Room was for the most part deep in slumber. It had been a slow mid-October Wednesday night. Mark Greene is dozing in Exam 8, while Carter was propping his feet up in the lounge glancing through _The Annals of Emergency Medicine_. Up in the OR, Elizabeth Corday was closing the abdomen on her first solo pheochromocytoma repair.

At the admit desk Jerry is deeply engrossed in his _Mad Magazine_. Meanwhile, Carol, Hallah, and Chuny are bickering over who has the lead in the "ER Pot" standings. Suddenly, the MICN began to blare.

"County General, this is Unit 49 on One-Bravo, over"

Carol answered the device, "This is County, over"

"All right County, 39 year old male. MVA. BP 160/90. He's tachy at 140. ETA is seven to ten." the voice of paramedic Doris Pickman raped.

"Roger, 49"

Carol quickly roused Jerry from his magazine and paged Drs. Greene and Corday. Mark quickly awoke, momentarily fumbled with his glasses and then proceeded to the ambulance bay. Elizabeth took a bit longer. She had just curled up for a nap in the surgeons lounge when she got the page. She would arrive in the ER for another ten minutes.

Pickman and Zadro wheeled the gurney into Trauma 2 quickly. Mark saw the face and froze.

"Oh my god, its Doug." said the ER attending. "Christ."

Carter came into the room. His reaction was quite similar to Mark's.

"Okay, lets get to work. Carter, run it." barked Greene

"ABCs" he replied. "O2 Sat is 79. Resps are 8."

"Tube him"

"Give me a Mac 3 and a 8-0 ET tube."

"Do it. I'll check the breathing."

Mark pressed his stethoscope against Ross's chest. The right side of the chest was fairly normal. However, the left side had completely absent breath sounds. Dr. Greene knew that in blunt trauma this could only mean one thing.

"He's got a hemopneumothorax" said Mark, "Get me a chest tube tray with 36 French."

Elizabeth Corday finally entered the trauma room. She quickly began to access the patient.

"His abdomen is tender and distended" the British surgeon announced. "Call the OR we've got to red-line him."

She began to prepare Doug for the trip when Halah stated "Wait BP is dropping fast. His is only 90/45."

"Shit" said Mark silently "Okay; we need o-neg. Carter?"

"4 units?" he replied.

"Sounds good" said Elizabeth "Meanwhile hang two liters of lactated ringers."

"Labs?" asked Carter

"CBC, chem 7, coag panel, dip a urine, spin a crit, type and cross for eight, and knowing Doug get me a BAL" responded Mark.

"Doug?" asked Elizabeth, looking at her patient's face for the first time. "Oh, Mark. Are you alright?"

"Yeah. I suppose."

"Crit is only 22" said Chuny Marquez, walking in with a lab sheet and a chest tube tray. "Blood alcohol is 352."

She handed the chest tube tray to Corday. She told Carter to begin when he saw his medical student, Lucy Knight, pass by on her way to begin her shift. Carter quickly motioned her in and asked if she had ever done a chest tube before. She responded that she hadn't.

"Is it all right Dr. Corday?" he asked.

"By all means." she responded.

"Okay. Lucy this is a hemopnumo. Do you want to take a posterior or anterior approach?" Carter asked.

"Posterior" the fourth year student replied uncertainly.

"Right. Now identify the fifth intercostal space."

She pointed to the chest at a directly parallel to Doug's nipple. Carter repositioned her slightly lower and handed her a #10 scalpel.

"Now make an incision parallel to the rib about four centimeters long."

After confirming that she had done so, he continued "Good. Now identify the intercostals facia. Once you do that you want to take the tonsillar clamp and advance it into the plural space."

"I'm there" said Lucy.

"Okay" said Cater "Don't advance any farther. Spread the clamp wide to open the tract."

Lucy did so, then asked "Now my finger, right?"

After getting confirmation she inserted her finger and said "Yeah, I'm in."

"Okay, now guide the tube in with your finger. You'll know when its in."

And, indeed she did for as soon as the tube was inserted a rush of blood spurted on to the green tile floor. This was quickly fixed when Chuny connected the tube to suction. The nurses next words brought bad news.

"He's lost almost a liter." she said.

"BP is 60 palp" reported Halah

"Where the hell is that blood?" shouted Elizabeth.

"Carol is bringing it"

"Oh God, Carol" said Mark.

Carol Hathaway walked into the trauma room with o-negative packed red blood cells. She had already begun to hang the blood on the rapid infuser when she looked down. She looked down at the gurney and collapsed on the floor.

"Carol!" shouted Mark "Okay. Get her into Trauma 2. Lizzie, can you take it from here?"

"Of course. I'm just about to take him up."


End file.
